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Maekawa K, Ikeuchi T, Shinkai S, Hirano H, Ryu M, Tamaki K, Yatani H, Kuboki T, Kimura‐Ono A, Kikutani T, Suganuma T, Ayukawa Y, Gonda T, Ogawa T, Fujisawa M, Ishigaki S, Watanabe Y, Kitamura A, Taniguchi Y, Fujiwara Y, Edahiro A, Ohara Y, Furuya J, Nakajima J, Umeki K, Igarashi K, Horibe Y, Kugimiya Y, Kawai Y, Matsumura H, Ichikawa T, Ohkawa S, Baba K. Impact of number of functional teeth on independence of Japanese older adults. Geriatr Gerontol Int 2022; 22:1032-1039. [PMID: 36408675 PMCID: PMC10099778 DOI: 10.1111/ggi.14508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 10/18/2022] [Accepted: 10/22/2022] [Indexed: 11/22/2022]
Abstract
AIM To examine the relationship between the number of present and functional teeth at baseline and future incidence of loss of independence. METHODS Participants were community-dwelling older individuals who participated in a comprehensive geriatric health examination conducted in Kusatsu town, Japan, between 2009 and 2015. The primary endpoint was the incidence of loss of independence among participants, defined as the first certification of long-term care insurance in Japan. The numbers of present and functional teeth at baseline were determined via an oral examination. Demographics, clinical variables (e.g., history of chronic diseases and psychosocial factors), blood nutritional markers, physical functions, and perceived masticatory function were assessed. RESULTS This study included 1121 individuals, and 205 individuals suffered from loss of independence during the follow-up period. Kaplan-Meier estimates of loss of independence for participants with smaller numbers of present and functional teeth were significantly greater than for those with larger numbers of teeth. Cox proportional hazard analyses indicated that a smaller number of present teeth was not a significant risk factor after adjusting for demographic characteristics. However, the number of functional teeth was a significant risk factor after the adjustment (hazard ratio: 1.975 [1.168-3.340]). Additionally, higher hazard ratios were observed in other adjusted models, but they were not statistically significant. CONCLUSIONS The number of functional teeth may be more closely related to the future incidence of loss of independence than the number of present teeth. This novel finding suggests that prosthodontic rehabilitation for tooth loss possibly prevents the future incidence of this life-event. Geriatr Gerontol Int 2022; 22: 1032-1039.
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Affiliation(s)
- Kenji Maekawa
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | | | - Shoji Shinkai
- Tokyo Metropolitan Institute of Gerontology Tokyo Japan
- Kagawa Nutrition University Sakado Japan
| | | | - Masahiro Ryu
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Tokyo Dental College Tokyo Japan
| | - Katsushi Tamaki
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Kanagawa Dental University Graduate School Yokosuka Japan
| | - Hirofumi Yatani
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Osaka University Graduate School of Dentistry Osaka Japan
| | - Takuo Kuboki
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Aya Kimura‐Ono
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Okayama University Hospital Okayama Japan
| | - Takeshi Kikutani
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- The Nippon Dental University Tokyo Japan
| | - Takashi Suganuma
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Showa University School of Dentistry Tokyo Japan
| | - Yasunori Ayukawa
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Kyushu University Faculty of Dental Science Fukuoka Japan
| | - Tomoya Gonda
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Osaka University Graduate School of Dentistry Osaka Japan
| | - Toru Ogawa
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Tohoku University Graduate School of Dentistry Sendai Japan
| | - Masanori Fujisawa
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Meikai University School of Dentistry Sakado Japan
| | - Shoichi Ishigaki
- Research Planning and Promotion Committee Japan Prosthodontic Society Tokyo Japan
- Osaka University Graduate School of Dentistry Osaka Japan
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute of Gerontology Tokyo Japan
- Faculty of Dental Medicine Hokkaido University Sapporo Japan
| | | | - Yu Taniguchi
- National Institute for Environmental Studies Ibaraki Japan
| | | | - Ayako Edahiro
- Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | - Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology Tokyo Japan
| | | | | | - Kento Umeki
- Nihon University School of Dentistry at Matsudo Chiba Japan
| | | | | | | | - Yasuhiko Kawai
- Nihon University School of Dentistry at Matsudo Chiba Japan
| | | | - Tetsuo Ichikawa
- Tokushima University Graduate School Institute of Biomedical Sciences Tokushima Japan
| | - Shuji Ohkawa
- Meikai University School of Dentistry Sakado Japan
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Kimura-Ono A, Maekawa K, Kuboki T, Nawachi K, Fujisawa M, Sato H, Aita H, Koyama S, Hideshima M, Sato Y, Wake H, Nagao K, Kodaira-Ueda Y, Tamaki K, Sadamori S, Tsuga K, Nishi Y, Sawase T, Koshino H, Masumi SI, Sakurai K, Ishibashi K, Ohyama T, Akagawa Y, Hirai T, Sasaki K, Koyano K, Yatani H, Matsumura H, Ichikawa T, Ohkawa S, Baba K. Prosthodontic treatment can improve the ingestible food profile in Japanese adult outpatients. J Prosthodont Res 2022; 67:189-195. [PMID: 35644569 DOI: 10.2186/jpr.jpr_d_22_00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To investigate the effect of prosthodontic treatment on the ingestible food profile in adult Japanese outpatients, and to identify the related risk factors that can deteriorate the profile. METHODS The participants were 277 outpatients who visited university-based specialty clinics in Japan for prosthodontic treatment. The demographic data, number of present teeth assessed via intraoral examination, and oral health-related quality of life assessed by the total Oral Health Impact Profile (OHIP-J54) scores of all participants were recorded before treatment. Ingestible food profile score (IFS) was recorded using a validated food intake questionnaire. Eligible participants who answered the questionnaire before and after treatment were categorized into five groups based on the prosthodontic treatments they received (i.e., crowns, bridges, removable partial dentures, removable complete dentures, and removable complete and partial dentures). RESULTS Multivariate analysis of covariance revealed a statistically significant main effect of prosthodontic intervention (time course: before and after treatment) on mean IFS (P=0.035, F=4.526), even after adjusting for covariates (age, number of present teeth, and treatment modality). Multiple linear regression analysis revealed that the low number of present teeth (r=0.427, P<0.001) and a high OHIP-J54 total score (r=-0.519, P<0.001) of the patients at the baseline were significantly associated with their baseline IFSs, even after adjusting for confounding variables. CONCLUSIONS The findings of this multicenter follow-up study indicate the importance of prosthodontic rehabilitation in improving patients' ingestible food profiles.
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Affiliation(s)
- Aya Kimura-Ono
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Kenji Maekawa
- Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Takuo Kuboki
- Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Kumiko Nawachi
- Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | | | - Hironobu Sato
- Fukuoka Dental College Graduate School of Dental Science, Japan
| | - Hideki Aita
- Health Sciences University of Hokkaido School of Dentistry, Japan
| | | | - Masayuki Hideshima
- Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Japan
| | - Yuji Sato
- Showa University School of Dentistry, Japan
| | - Hiroyuki Wake
- Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Japan
| | - Kan Nagao
- Tokushima University Graduate School of Biomedical Sciences, Japan
| | | | | | - Shinsuke Sadamori
- Ministry of Health, Labour, and Welfare, Chugoku-Shikoku Regional Bureau of Health and Welfare, Japan
| | - Kazuhiro Tsuga
- Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Yasuhiro Nishi
- Kagoshima University Graduate School of Medical and Dental Sciences, Japan
| | - Takashi Sawase
- Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Hisashi Koshino
- Health Sciences University of Hokkaido School of Dentistry, Japan
| | | | | | | | - Takashi Ohyama
- Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Japan
| | - Yasumasa Akagawa
- Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Toshihiro Hirai
- Health Sciences University of Hokkaido School of Dentistry, Japan
| | | | | | | | | | - Tetsuo Ichikawa
- Tokushima University Graduate School of Biomedical Sciences, Japan
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3
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Tanoue N, Takeuchi Y, Furuchi M, Yamamori T, Ohkawa S. Direct bonded fixed partial denture with an artificial denture tooth as a pontic. Jpn Dent Sci Rev 2021; 57:154-157. [PMID: 34539940 PMCID: PMC8441073 DOI: 10.1016/j.jdsr.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 11/15/2022] Open
Abstract
Background The present review aimed to investigate the feasibility and clinical effectiveness of a direct bonded fixed partial denture (DBFPD) based on available literature. The efficiency of a DBFPD is mainly affected by the type of artificial denture tooth, the type of luting agent, and the adhesive preparation. Methods The parameters were reviewed based on the in vitro and in vivo studies conducted. An acrylic resin tooth or a composite resin tooth for removable dentures should be used as the artificial tooth for the pontic. Results Considering the luting agent, a methyl methacrylate-based resin luting agent, which has low mechanical strength but is capable of plastic deformation and could sustain for a long time, should be used. Appropriate pre-adhesive treatment should be performed on both the artificial and abutment teeth. The cases in which a DBFPD can be applied are limited to one missing anterior tooth, as long as it is not overstressed. Patient cooperation in cases of occlusion seems to be another prerequisite. Conclusion Knowledge and selection of the material and case indications are essential, and patient cooperation is pertinent in studying the long-term prognosis of a DBFPD.
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Affiliation(s)
- Naomi Tanoue
- Division of Pediatric Dentistry, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan
| | - Yoshimasa Takeuchi
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-Ku, Tokyo 101-8310, Japan
| | - Mika Furuchi
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-Ku, Tokyo 101-8310, Japan
| | - Tetsuo Yamamori
- Department of Prosthetic Dentistry, Ohu University School of Dentistry, 31-1 Misumido, Tomita, Koriyama, Fukushima 963-9361, Japan
| | - Shuji Ohkawa
- Division of Removable Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama 350-0283, Japan
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Masumi SI, Makihara E, Yamamori T, Ohkawa S. Effectiveness of denture space recording method in the prosthetic treatment of edentulous patients. J Prosthodont Res 2021; 66:221-225. [PMID: 34511559 DOI: 10.2186/jpr.jpr_d_21_00035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To present a clinical rationale for the effectiveness of denture space recording methods for the prosthetic treatment of edentulous patients through a review of the literature. STUDY SELECTION A total of 3167 studies were extracted from a search of four terms, namely denture space, neutral zone technique, flange technique, and piezography using PubMed and J-STAGE databases. A total of 57 documents that matched the inclusion and exclusion criteria were selected. RESULTS From the extracted articles, the clinical application of denture space recording methods was found to be effective in edentulous patients with severe ridge resorption. The relationship between the labiolingual and buccolingual pressure in patients with neuromuscular problems or with mandibular or lingual defects differs from those without it, so a stable prosthesis ca n be easily fabricated by locating the neutral zone using denture space recording methods. CONCLUSIONS The literature on denture space recording methods suggests that its application on challenging cases of edentulous patients is useful in providing prostheses with improved retention and stability.
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Affiliation(s)
- Shin-Ichi Masumi
- Japan Prosthodontic Society.,Division of Occlusion and Maxillofacial Reconstruction, Department of Oral Function, Kyushu Dental University, Fukuoka
| | - Eri Makihara
- Japan Prosthodontic Society.,Division of Occlusion and Maxillofacial Reconstruction, Department of Oral Function, Kyushu Dental University, Fukuoka
| | - Tetsuo Yamamori
- Chair of Dental Service Problem Committee, Japan Prosthodontic Society 2019-2020.,Department of Prosthetic Dentistry, Ohu University School of Dentistry, Fukushima
| | - Shuji Ohkawa
- President, Japan Prosthodontic Society 2019-2020.,Division of Removable Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Saitama
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5
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Affiliation(s)
- Shuji Ohkawa
- President, Japan Prosthodontic Society.,Division of Removable Prosthodontics Department of Restorative and Biomaterials Sciences Meikai University School of Dentistry
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Tanoue N, Matsumura H, Yamamori T, Ohkawa S. Longevity of resin-bonded fixed partial dentures made of metal alloys: A review of the literature. J Prosthodont Res 2021; 65:267-272. [PMID: 33612664 DOI: 10.2186/jpr.jpr_d_20_00122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Purpose In this review, we evaluate the survival rate of resin-bonded fixed partial dentures (RBFPDs) made of metal alloys.Methods An electronic search of English peer-reviewed dental literature on PubMed was conducted to identify all publications reporting on RBFPDs made of metal alloys until March 2019. The searched keywords were: bridge OR fixed partial denture OR fixed prosthesis OR fixed prostheses AND resin bonded AND metal OR alloy AND survival OR longevity (RBFPD was not included). Furthermore, the "Related Articles" feature of PubMed was used to identify further references of interest during the primary search. A definitive list of articles was screened to extract qualitative data after the application of the inclusion and exclusion criteria, and the results were analyzed.Results Overall, 977 publications were found through an electronic and manual search, out of which 130 articles were selected after screening based on title and abstract. A total of 52 publications passed the second review phase after assessment for eligibility, from which 24 studies were excluded after full-text screening. Finally, a total of 28 studies were selected.Conclusions The survival rate of RBFPDs differed greatly depending on the type of metal alloy, adhesion system, and observation period assessed, e.g. the 10-year survival rate ranged from 18% to 88%. The wide range of survival rates of the RBFPDs reported indicates that though RBFPD is a reliable prosthesis, it is prone to failure if some processes are not completed.
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Affiliation(s)
- Naomi Tanoue
- Department of Special Care Dentistry, Nagasaki University Hospital, Nagasaki, Japan
| | - Hideo Matsumura
- Department of Fixed Prosthodontics, Nihon University School of Dentistry, Tokyo, Japan
| | - Tetsuo Yamamori
- Department of Prosthetic Dentistry, School of Dentistry, Ohu University, Koriyama, Japan
| | - Shuji Ohkawa
- President of Japan Prosthodontic Society, Division of Removable Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
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Maekawa K, Ikeuchi T, Shinkai S, Hirano H, Ryu M, Tamaki K, Yatani H, Kuboki T, Kimura-Ono A, Kikutani T, Suganuma T, Ayukawa Y, Gonda T, Ogawa T, Fujisawa M, Ishigaki S, Watanabe Y, Kitamura A, Taniguchi Y, Fujiwara Y, Edahiro A, Ohara Y, Furuya J, Nakajima J, Umeki K, Igarashi K, Horibe Y, Kugimiya Y, Kawai Y, Matsumura H, Ichikawa T, Ohkawa S. Number of functional teeth more strongly predicts all-cause mortality than number of present teeth in Japanese older adults. Geriatr Gerontol Int 2020; 20:607-614. [PMID: 32227400 PMCID: PMC7317780 DOI: 10.1111/ggi.13911] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 02/11/2020] [Accepted: 03/03/2020] [Indexed: 12/20/2022]
Abstract
Aim Previous studies on the association between intraoral conditions and mortality in community‐dwelling older individuals reported that fewer present teeth (PT) are significant risk factors for mortality. However, how the number of PT relative to the number of functional teeth (FT), including both present and rehabilitated teeth, influences mortality has not been investigated fully. This study examined the impact of the number of FT on mortality among community‐dwelling Japanese older adults. Methods This study was a retrospective, observational and population‐based follow‐up study, which examined 1188 older individuals who participated in an annual geriatric health examination from 2009 to 2015. The average follow‐up period was 1697.0 ± 774.5 days. The primary outcome was all‐cause mortality at follow‐up. The numbers of PT and FT of each participant were counted during an oral examination. In addition, demographics, clinical variables, blood nutrient markers, physical functions and perceived masticatory function were measured. Results Kaplan–Meier analysis, followed by a log‐rank test, revealed that fewer PT (P < 0.001) and FT (P = 0.002) were significantly associated with a reduced survival rate. Cox's proportional hazard analysis indicated that the number of FT, but not the number of PT, was a significant independent mortality risk factor after adjusting for demographics, clinical variables, nutrient markers and physical functioning (P = 0.036, hazard ratio: 2.089). Conclusions Current results suggest that the number of FT more strongly predicts all‐cause mortality than the number of PT among community‐dwelling older adults. Further studies are necessary to consider the confounding of socioeconomic status and disability status. Geriatr Gerontol Int 2020; ••: ••–••.
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Affiliation(s)
- Kenji Maekawa
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Tomoko Ikeuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shoji Shinkai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Masahiro Ryu
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Tokyo Dental College, Tokyo, Japan
| | - Katsushi Tamaki
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Kanagawa Dental University Graduate School, Yokosuka, Japan
| | - Hirofumi Yatani
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takuo Kuboki
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | | | - Aya Kimura-Ono
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Okayama University Hospital, Okayama, Japan
| | - Takeshi Kikutani
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,The Nippon Dental University, Tokyo, Japan
| | - Takashi Suganuma
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Showa University School of Dentistry, Tokyo, Japan
| | - Yasunori Ayukawa
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Kyushu University Faculty of Dental Science, Fukuoka, Japan
| | - Tomoya Gonda
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Toru Ogawa
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Masanori Fujisawa
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Meikai University School of Dentistry, Sakado, Japan
| | - Shoichi Ishigaki
- Research Planning and Promotion Committee, Japan Prosthodontic Society, Tokyo, Japan.,Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yutaka Watanabe
- Hokkaido University Faculty of Dental Medicine, Sapporo, Japan
| | | | - Yu Taniguchi
- National Institute for Environmental Studies, Ibaraki, Japan
| | | | - Ayako Edahiro
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | | | - Kento Umeki
- Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | | | | | | | - Yasuhiko Kawai
- Nihon University School of Dentistry at Matsudo, Chiba, Japan
| | | | - Tetsuo Ichikawa
- Tokushima University Graduate School, Institute of Biomedical Sciences, Tokushima, Japan
| | - Shuji Ohkawa
- Meikai University School of Dentistry, Sakado, Japan
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Okuyama H, Ikeda M, Okusaka T, Furuse J, Furukawa M, Ohkawa S, Hosokawa A, Kojima Y, Yamaguchi K, Murohisa G, Shioji K, Ishii H, Mizuno N, Kojima M, Yamanaka T. A phase II study of everolimus in patients with unresectable pancreatic neuroendocrine carcinoma refractory or intolerant to platinum-containing chemotherapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy293.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Okusaka T, Miyakawa H, Fujii H, Nakamori S, Satoh T, Hamamoto Y, Ito T, Maguchi H, Matsumoto S, Ueno H, Ioka T, Boku N, Egawa S, Hatori T, Furuse J, Mizumoto K, Ohkawa S, Yamaguchi T, Yamao K, Funakoshi A, Chen JS, Cheng AL, Sato A, Ohashi Y, Tanaka M. Updated results from GEST study: a randomized, three-arm phase III study for advanced pancreatic cancer. J Cancer Res Clin Oncol 2017; 143:1053-1059. [PMID: 28210843 PMCID: PMC5427167 DOI: 10.1007/s00432-017-2349-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 01/24/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE The GEST study showed non-inferiority of S-1 but not superiority of gemcitabine plus S-1 (GS) to gemcitabine alone for overall survival with the data by the cut-off date of 31st July in 2010 for chemo-naïve patients with advanced pancreatic cancer. We considered it important to determine whether S-1 maintains non-inferiority after a long-term follow-up in the GEST study and to obtain a firm positive conclusion. In addition, it may be an interesting challenge to explore the efficacious profile of GS in the long-term follow-up study. Using the data from the follow-up period, background and efficacy in patients from Taiwan and Japan, as well as the rates of tumor shrinkage in locally advanced and metastatic patients (Waterfall plot) were also analyzed. METHODS The results of the primary analysis were reconfirmed, and subset analysis of overall survival and progression-free survival was performed based on the overall survival data updated by the cut-off date of 31st July in 2011. RESULTS The median follow-up period was 29.8 months, and 795 deaths occurred (95.6%). The median overall survival was 8.8 months for gemcitabine, 9.7 months for S-1 (hazard ratio [HR], 0.96; 97.5% confidence interval [CI], 0.79-1.17), and 9.9 months for GS (HR 0.91; 97.5% CI 0.75-1.11). In patients with performance status (PS) 0, the median overall survival was 9.8 months for gemcitabine, 10.9 months for S-1, and 10.5 months for GS. In patients with PS 1, the median overall survival was 6.2 months for gemcitabine, 6.3 months for S-1, and 9.6 months for GS. CONCLUSION Our survey reconfirmed the non-inferiority of S-1 to gemcitabine and showed S-1 can be used as one of the standard treatment options for advanced pancreatic cancer. TRIAL REGISTRATION ClinicalTrials.gov: NCT00498225.
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Affiliation(s)
- Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - H Miyakawa
- Division of Biliopancreatology, Sapporo Kosei General Hospital, Sapporo, Japan
| | - H Fujii
- Division of Clinical Oncology, Jichi Medical University, Tochigi, Japan
| | - S Nakamori
- Hepato-Biliary-Pancreatic Surgery, Osaka National Hospital, Osaka, Japan
| | - T Satoh
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Hamamoto
- Keio Cancer Center, Keio University Hospital, Tokyo, Japan
| | - T Ito
- Department of Medicine and Bioreguratory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - S Matsumoto
- Department of Medical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - H Ueno
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - T Ioka
- Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - N Boku
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - S Egawa
- Department of Surgery, Tohoku University, Sendai, Japan
| | - T Hatori
- Department of Surgery and Digestive Diseases Center, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University School of Medicine, Tokyo, Japan
| | - K Mizumoto
- Kyushu University Hospital Cancer Center, Fukuoka, Japan
| | - S Ohkawa
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - T Yamaguchi
- Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - K Yamao
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - A Funakoshi
- Division of Pancreatology, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - J S Chen
- Division of Hematology-Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| | - A L Cheng
- Department of Oncology, National Taiwan University Hospital, and National Taiwan University Cancer Center, Taipei, Taiwan, Republic of China
| | - A Sato
- Department of Medical Oncology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
| | - M Tanaka
- Department of Surgery, Shimonoseki City Hospital, Shimonoseki, Japan
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Ioka T, Komatsu Y, Mizuno N, Tsuji A, Ohkawa S, Tanaka M, Iguchi H, Ishiguro A, Kitano M, Satoh T, Yamaguchi T, Takeda K, Kida M, Eguchi K, Ito T, Munakata M, Itoi T, Furuse J, Hamada C, Sakata Y. Randomised phase II trial of irinotecan plus S-1 in patients with gemcitabine-refractory pancreatic cancer. Br J Cancer 2017; 116:464-471. [PMID: 28081543 PMCID: PMC5318973 DOI: 10.1038/bjc.2016.436] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/31/2016] [Accepted: 12/05/2016] [Indexed: 12/18/2022] Open
Abstract
Background: We aimed to compare the efficacy and safety of irinotecan/S-1 (IRIS) therapy with S-1 monotherapy in patients with gemcitabine-refractory pancreatic cancer. Methods: Patients were treated with oral S-1 (80–120 mg for 14 days every 4 weeks) plus intravenous irinotecan (100 mg m−2 on days 1 and 15 every 4 weeks; IRIS group) or oral S-1 group (80–120 mg daily for 28 days every 6 weeks). The primary endpoint was progression-free survival (PFS). Results: Of 137 patients enrolled, 127 were eligible for efficacy. The median PFS in the IRIS group and S-1 monotherapy group were 3.5 and 1.9 months, respectively (hazard ratio (HR)=0.77; 95% confidence interval (CI), 0.53–1.11; P=0.18), while the median overall survival (OS) were 6.8 and 5.8 months, respectively (HR=0.75; 95% CI, 0.51–1.09; P=0.13). Response rate was significantly higher in the IRIS group than in the S-1 monotherapy group (18.3% vs 6.0%, P=0.03). Grade 3 or higher neutropenia and anorexia occurred more frequently in the IRIS group. Conclusions: There was a trend for better PFS and OS in the IRIS group that could be a treatment arm in the clinical trials for gemcitabine-refractory pancreatic cancer.
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Affiliation(s)
- T Ioka
- Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan
| | - Y Komatsu
- Department of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, 5-chome, Kita 14 Jou Nishi, Kita-ku, Sapporo 060-8648, Japan
| | - N Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan
| | - A Tsuji
- Department of Medical Oncology, Kochi Health Sciences Center, 2125-1 Ike, Kochi 781-0111, Japan
| | - S Ohkawa
- Department of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center Hospital, 2-3-2 Nakao, Asahi-ku, Yokohama 241-8515, Japan
| | - M Tanaka
- Department of Surgery and Oncology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - H Iguchi
- Department of Gastroenterology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-chou, Matsuyama 791-0280, Japan
| | - A Ishiguro
- Department of Medical Oncology, Hirosaki University, 53 Hon-cho, Hirosaki 036-8562, Japan
| | - M Kitano
- Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2 Onohigashi, Osakasayama 589-8511, Japan
| | - T Satoh
- Faculty of Medicine, Department of Medical Oncology, Kinki University, 377-2 Onohigashi, Osakasayama 589-8511, Japan
| | - T Yamaguchi
- Division of Gastroenterology, Chiba Cancer Center Hospital, 666-2 Nitona-cho, Chuo-ku, Chiba 260-8717, Japan
| | - K Takeda
- Department of Clinical Oncology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojia-ku, Osaka 534-0021, Japan
| | - M Kida
- Department of Medicine, Kitasato University School of Medicine, 2-1-1 Asamizodai, Minami-ku, Sagamihara 252-0374, Japan
| | - K Eguchi
- Department of Internal Medicine, Medical Oncology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo 173-8605, Japan
| | - T Ito
- Department of Medicine and Bioregulatory Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - M Munakata
- Department of Medical Oncology, Misawa City Hospital, 164-65 Oazamisawaazahoriuchi, Misawa 033-0022, Japan
| | - T Itoi
- Department of Gastroenterological Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 166-0023, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, 181-8611, Japan
| | - C Hamada
- Faculty of Engineering, Tokyo University of Science, 6-3-1 Niijuku, Katsushika-ku, Tokyo 125-8585, Japan
| | - Y Sakata
- Department of Medical Oncology, Misawa City Hospital, 164-65 Oazamisawaazahoriuchi, Misawa 033-0022, Japan
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Tezuka S, Ueno M, Ohkawa S, Hirotani A, Totsuka Y, Moriya S, Kobayashi S, Morimoto M, Nakamura Y, Miyagi Y, Maeda S. 255P Predictive value of ERCC1, ERCC2, ERCC4, and glutathione S-transferase P1 for FOLFIRINOX in unresectable pancreatic cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw582.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Doi T, Yoh K, Shitara K, Takahashi H, Ueno M, Ohkawa S, Morimoto M, Kobayashi S, Okusaka T, Ueno H, Morizane C, Shiba S, Furuse J, Nagashima F, Naruge D, Okano N. First-in-man phase 1 study of TAS-114 in combination with S-1 in Japanese patients with advanced solid tumors. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32956-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Kobayashi S, Ueno M, Irie K, Goda Y, Moriya S, Tedzuka S, Ohkawa S, Morimoto M. 2378 Prognostic significance of a new proteomic profile in patients with advanced pancreatic adenocarcinoma. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31294-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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Ueno H, Nagase M, Hamamoto Y, Egawa S, Ohkawa S. 2375 Prognostic index based on the phase III study of gemcitabine plus S-1, S-1 alone or gemcitabine alone in patients with advanced pancreatic cancer (GEST study). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31291-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Chau I, Park J, Ryoo B, Yen C, Poon R, Pastorelli D, Blanc J, Kudo M, Pfiffer T, Hatano E, Chung H, Kubackova K, Phelip J, Brandi G, Ohkawa S, Li C, Okusaka T, Yang L, Abada P, Zhu A. 2337 Ramucirumab (RAM) as a second-line treatment in patients with advanced hepatocellular carcinoma (HCC) following first-line therapy with sorafenib in the randomized phase III REACH study: Analysis of alpha-fetoprotein (AFP) kinetics during treatment. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31253-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Fuchs CS, Azevedo S, Okusaka T, Van Laethem JL, Lipton LR, Riess H, Szczylik C, Moore MJ, Peeters M, Bodoky G, Ikeda M, Melichar B, Nemecek R, Ohkawa S, Świeboda-Sadlej A, Tjulandin SA, Van Cutsem E, Loberg R, Haddad V, Gansert JL, Bach BA, Carrato A. A phase 3 randomized, double-blind, placebo-controlled trial of ganitumab or placebo in combination with gemcitabine as first-line therapy for metastatic adenocarcinoma of the pancreas: the GAMMA trial. Ann Oncol 2015; 26:921-927. [PMID: 25609246 DOI: 10.1093/annonc/mdv027] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 12/30/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This double-blind, phase 3 study assessed the efficacy and safety of ganitumab combined with gemcitabine as first-line treatment of metastatic pancreatic cancer. PATIENTS AND METHODS Patients with previously untreated metastatic pancreatic adenocarcinoma were randomly assigned 2 : 2 : 1 to receive intravenous gemcitabine 1000 mg/m(2) (days 1, 8, and 15 of each 28-day cycle) plus placebo, ganitumab 12 mg/kg, or ganitumab 20 mg/kg (days 1 and 15 of each cycle). The primary end point was overall survival (OS). Secondary end points included progression-free survival (PFS), safety, and efficacy by levels of circulating biomarkers. RESULTS Overall, 322 patients were randomly assigned to placebo, 318 to ganitumab 12 mg/kg, and 160 to ganitumab 20 mg/kg. The study was stopped based on results from a preplanned futility analysis; the final results are reported. Median OS was 7.2 months [95% confidence interval (CI), 6.3-8.2] in the placebo arm, 7.0 months (95% CI, 6.2-8.5) in the ganitumab 12-mg/kg arm [hazard ratio (HR), 1.00; 95% CI, 0.82-1.21; P = 0.494], and 7.1 months (95% CI, 6.4-8.5) in the ganitumab 20-mg/kg arm (HR, 0.97; 95% CI, 0.76-1.23; P = 0.397). Median PFS was 3.7, 3.6 (HR, 1.00; 95% CI, 0.84-1.20; P = 0.520), and 3.7 months (HR, 0.97; 95% CI, 0.77-1.22; P = 0.403), respectively. No unexpected toxicity was observed with ganitumab plus gemcitabine. The circulating biomarkers assessed [insulin-like growth factor-1 (IGF-1), IGF-binding protein-2, and -3] were not associated with a treatment effect on OS or PFS by ganitumab. CONCLUSION Ganitumab combined with gemcitabine had manageable toxicity but did not improve OS, compared with gemcitabine alone in unselected patients with metastatic pancreatic cancer. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT01231347.
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Affiliation(s)
- C S Fuchs
- Department of Medical Oncology/Solid Tumor Oncology, Dana-Farber Cancer Institute, Boston, USA.
| | - S Azevedo
- Oncology Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - T Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - J-L Van Laethem
- Department of Gastroenterology, Erasme University Hospital, Brussels, Belgium
| | - L R Lipton
- Medical Oncology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - H Riess
- Department of Hematology, Oncology, and Tumor Immunology, Charité University, Berlin, Germany
| | - C Szczylik
- Department of Oncology, Military Institute of Health Services, Warsaw, Poland
| | - M J Moore
- Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - M Peeters
- Department of Oncology, Antwerp University Hospital, Edegum, Belgium
| | - G Bodoky
- Department of Oncology, St László Hospital, Budapest, Hungary
| | - M Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - B Melichar
- Department of Oncology, Palacký University Medical School and Teaching Hospital, Olomouc
| | - R Nemecek
- Department of Oncology, Masaryk University Medical School and Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - S Ohkawa
- Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan
| | - A Świeboda-Sadlej
- Department of Haematology, Oncology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - S A Tjulandin
- Department of Clinical Pharmacology and Chemotherapy, Russian Cancer Research Center, Moscow, Russia
| | - E Van Cutsem
- Digestive Oncology, University Hospitals Gasthuisberg/Leuven and KU Leuven, Leuven, Belgium
| | - R Loberg
- Medical Sciences, Amgen Inc., Thousand Oaks, USA
| | - V Haddad
- Global Biostatistical Science, Amgen Ltd, Cambridge, UK
| | | | - B A Bach
- Development Oncology Therapeutics, Amgen Inc., Thousand Oaks, USA
| | - A Carrato
- Medical Oncology Department, University Hospital Ramon y Cajal, Madrid, Spain
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Matsuyama M, Ishii H, Furuse J, Ohkawa S, Maguchi H, Mizuno N, Yamaguchi T, Ioka T, Ajiki T, Ikeda M, Hakamada K, Yamamoto M, Yamaue H, Eguchi K, Ichikawa W, Miyazaki M, Ohashi Y, Sasaki Y. Phase II trial of combination therapy of gemcitabine plus anti-angiogenic vaccination of elpamotide in patients with advanced or recurrent biliary tract cancer. Invest New Drugs 2014; 33:490-5. [PMID: 25502982 PMCID: PMC4387249 DOI: 10.1007/s10637-014-0197-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 12/03/2014] [Indexed: 12/31/2022]
Abstract
Background Elpamotide is an HLA-A*24:02-restricted epitope peptide of vascular endothelial growth factor receptor 2 (VEGFR-2) and induces cytotoxic T lymphocytes (CTLs) against VEGFR-2/KDR. Given the high expression of VEGFR-2 in biliary tract cancer, combination chemoimmunotherapy with elpamotide and gemcitabine holds promise as a new therapy. Patients and Methods Patients with unresectable advanced or recurrent biliary tract cancer were included in this single-arm phase II trial, with the primary endpoint of overall survival. Survival analysis was performed in comparison with historical control data. The patients concurrently received gemcitabine once a week for 3 weeks (the fourth week was skipped) and elpamotide once a week for 4 weeks. Results Fifty-five patients were registered, of which 54 received the regimen and were included in the full analysis set as well as the safety analysis set. Median survival was 10.1 months, which was longer than the historical control, and the 1-year survival rate was 44.4 %. Of these patients, injection site reactions were observed in 64.8 %, in whom median survival was significantly longer (14.8 months) compared to those with no injection site reactions (5.7 months). The response rate was 18.5 %, and all who responded exhibited injection site reactions. Serious adverse reactions were observed in five patients (9 %), and there were no treatment-related deaths. Conclusion Gemcitabine and elpamotide combination therapy was tolerable and had a moderate antitumor effect. For future development of therapies, it will be necessary to optimize the target population for which therapeutic effects could be expected.
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Affiliation(s)
- Masato Matsuyama
- Gastroenterological Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan,
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Nakamae A, Ochi M, Deie M, Adachi N, Shibuya H, Ohkawa S, Hirata K. Clinical outcomes of second-look arthroscopic evaluation after anterior cruciate ligament augmentation. Bone Joint J 2014; 96-B:1325-32. [DOI: 10.1302/0301-620x.96b10.34282] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We report the clinical outcome and findings at second-look arthroscopy of 216 patients (mean age 25 years (11 to 58)) who underwent anterior cruciate ligament (ACL) reconstruction or augmentation. There were 73 single-bundle ACL augmentations (44 female, 29 male), 82 double-bundle ACL reconstructions (35 female, 47 male), and 61 single-bundle ACL reconstructions (34 female, 27 male). In 94 of the 216 patients, proprioceptive function of the knee was evaluated before and 12 months after surgery using the threshold to detect passive motion test. Second-look arthroscopy showed significantly better synovial coverage of the graft in the augmentation group (good: 60 (82%), fair: 10 (14%), poor: 3 (4%)) than in the other groups (p = 0.039). The mean side-to-side difference measured with a KT-2000 arthrometer was 0.4 mm (-3.3 to 2.9) in the augmentation group, 0.9 mm (-3.2 to 3.5) in the double-bundle group, and 1.3 mm (-2.7 to 3.9) in the single-bundle group: the result differed significantly between the augmentation and single-bundle groups (p = 0 .013). No significant difference in the Lysholm score or pivot-shift test was seen between the three groups (p = 0.09 and 0.65, respectively). In patients with good synovial coverage, three of the four measurements used revealed significant improvement in proprioceptive function (p = 0.177, 0.020, 0.034, and 0.026). We conclude that ACL augmentation is a reasonable treatment option for patients with favourable ACL remnants. Cite this article: Bone Joint J 2014;96-B:1325–32
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Affiliation(s)
- A. Nakamae
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M. Ochi
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M. Deie
- Department of Musculoskeletal Functional Research and Regeneration, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - N. Adachi
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H. Shibuya
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S. Ohkawa
- Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - K. Hirata
- Hiroshima University Hospital, Division
of Clinical Support, Hiroshima, Japan
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Kobayashi S, Ueno M, Ohkawa S, Gouda Y, Irie K, Morimoto M. Second-Line Therapy of S-1 for Patients with Advanced Biliary Tract Cancer After Failure to Cisplatin Plus Gemcitabine. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt459.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Yamada Y, Boku N, Nishina T, Yamaguchi K, Denda T, Tsuji A, Hamamoto Y, Konishi K, Tsuji Y, Amagai K, Ohkawa S, Fujita Y, Nishisaki H, Kawai H, Takashima A, Mizusawa J, Nakamura K, Ohtsu A. Impact of excision repair cross-complementing gene 1 (ERCC1) on the outcomes of patients with advanced gastric cancer: correlative study in Japan Clinical Oncology Group Trial JCOG9912. Ann Oncol 2013; 24:2560-2565. [PMID: 23884439 DOI: 10.1093/annonc/mdt238] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Since the best chemotherapy regimen for each patient with advanced gastric cancer is uncertain, we aimed to identify molecular prognostic or predictive biomarkers from biopsy specimens in JCOG9912, a randomized phase III trial for advanced gastric cancer. PATIENTS AND METHODS Endoscopic biopsy specimens from primary lesions were collected in 445 of 704 randomized patients in JCOG9912. We measured the mRNA expression of excision repair cross-complementing group 1 (ERCC1), thymidylate synthase, dihydropyrimidine dehydrogenase, and five other genes, then, categorized them into low and high groups relative to the median, and examined whether gene expression was associated with efficacy end point. RESULTS Multivariate analyses showed that high ERCC1 expression [HR 1.37; 95% confidence interval (CI) 1.08-1.75; P = 0.010], performance status ≥ 1 (HR 1.45; 95% CI 1.13-1.86; P = 0.004), and number of metastatic sites ≥ 2 (HR 1.66; 95% CI 1.28-1.86; P < 0.001) were associated with a poor prognosis, and recurrent disease (versus unresectable; HR 0.75; 95% CI 0.56-1.00; P = 0.049) was associated with a favorable prognosis. None of these molecular factors were a predictive marker for choosing irinotecan plus cisplatin or 5-fluorouracil rather than S-1. CONCLUSION These correlative analyses suggest that ERCC1 is an independent prognostic factor for overall survival in the first-line treatment of gastric cancer. CLINICAL TRIAL NUMBER C000000062, www.umin.ac.jp.
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Affiliation(s)
- Y Yamada
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo.
| | - N Boku
- Department of Clinical Oncology, St. Marianna University School of Medicine, Kawasaki
| | - T Nishina
- Department of Gastrointestinal Medical Oncology, Shikoku Cancer Center, Matsuyama
| | - K Yamaguchi
- Department of Gastroenterology, Saitama Cancer Center, Kita-adachi
| | - T Denda
- Department of Gastroenterology, Chiba Cancer Center, Chiba
| | - A Tsuji
- Department of Clinical Oncology, Kobe City Medical Center General Hospital, Kobe
| | - Y Hamamoto
- Department of Gastroenterology, Keio University, School of Medicine, Tokyo
| | - K Konishi
- Department of Gastroenterology, Showa University, School of Medicine, Tokyo
| | - Y Tsuji
- Department of Clinical Oncology, Tonan Hospital, Sapporo
| | - K Amagai
- Department of Gastroenterology, Ibaraki Prefectural Central Hospital, Kasama
| | - S Ohkawa
- Department of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama
| | - Y Fujita
- Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Yokohama
| | - H Nishisaki
- Department of Gastroenterological Oncology, Hyogo Cancer Center, Akashi
| | - H Kawai
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya
| | - A Takashima
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo
| | - J Mizusawa
- JCOG Data Center/Operations Office, National Cancer Center, Tokyo
| | - K Nakamura
- JCOG Data Center/Operations Office, National Cancer Center, Tokyo
| | - A Ohtsu
- National Cancer Center, Exploratory Oncology Research and Clinical Trial Center, Kashiwa, Japan
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Yoshii T, Ohkawa S, Tamai S, Kameda Y. Clinical outcome of endoscopic mucosal resection for esophageal squamous cell cancer invading muscularis mucosa and submucosal layer. Dis Esophagus 2013; 26:496-502. [PMID: 22676622 DOI: 10.1111/j.1442-2050.2012.01370.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
When a tumor invades the muscularis mucosa and submucosal layer (T1a-MM and T1b in Japan), esophageal squamous cell cancer poses 10-50% risk of lymph node metastasis. By this stage of esophageal cancer, surgery, although very invasive, is the standard radical therapy for the patients. Endoscopic mucosal resection (EMR) is the absolutely curable treatment for cancer in the superficial mucosal layer. Because of its minimal invasiveness, the indications of EMR may be expanded to include the treatment of T1a-MM and T1b esophageal carcinoma. To date, the clinical outcomes of EMR for T1a-MM and T1b patients have not been fully elucidated. Here, the retrospective analysis of the clinical outcomes is reported. Between January 1994 and December 2007, 247 patients underwent EMR at Kanagawa Cancer Center. Of these individuals, 44 patients with 44 lesions fulfilled the following criteria: (i) extended EMR treatment for clinical T1a-MM and T1b tumor; (ii) diagnosis of clinical N0M0; and (iii) follow up for at least 1 year, and negative vertical margin. These patients were reviewed for their clinical features and outcomes. Statistical analyses were performed by the Kaplan-Meier methods, the Chi-square test, and the Cox proportional hazard model. P-value of <0.05 was considered statistically significant. The data were analyzed in February 2009. Based on the informed consent and their general health conditions, 44 patients decided the following treatments immediately after the EMR: 2 underwent surgery, 1 underwent adjuvant chemotherapy, and 41 selected follow up without any additional therapy. Of the 41 patients, 20 selected this course by choice, 12 because of severe concurrent diseases, 2 because of poor performance status, and 7 because of other multiple primary cancers. Twelve patients died; two were cause specific (4.5%), eight from multiple primary cancers, one from severe concurrent diseases, and one from unknown causes. No critical complications were noted. Median follow-up time was 51 months (12-126). Five patients ultimately developed lymph node metastasis. One patient with adjuvant chemotherapy required surgery, and another was treated with chemotherapy whose subsequent death was cause specific. The other three patients received chemoradiotherapy and have not shown cause-specific death. Overall and cause-specific survival rates at 5 years were 67.3% and 91.8%, respectively. Among 41 patients treated by EMR alone, only one died from primary esophageal cancer (2.4%), and overall and cause-specific survival rates at 5 years were 75.6% and 97.6%, respectively. Multivariate analysis revealed that severe concurrent diseases including multiple primary cancers and the administration of 5-fluorouracil-based chemotherapy for multiple primary cancers significantly influenced survival (P= 0.025, hazard ratio [HR] 13.1 [95% confidence interval 1.5-114]) and (P= 0.037, HR 0.213 [95% confidence interval 0.05-0.914]), respectively. Eight and six patients developed metachronous esophageal squamous cell cancer and local recurrence, respectively. With the exception of one patient, they could be retreated endoscopically. EMR is a reasonable option for the patients with T1a-MM and T1b esophageal carcinoma without clinical metastasis, especially for the individuals with severe concurrent diseases. The prognostic factors for the benefit of EMR in such cases should be further examined.
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Affiliation(s)
- T Yoshii
- Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Kanagawa, 241-0815, Japan.
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Watanabe T, Morinaga S, Akaike M, Numata M, Tamagawa H, Yamamoto N, Shiozawa M, Ohkawa S, Kameda Y, Nakamura Y, Miyagi Y. The cellular level of histone H3 lysine 4 dimethylation correlates with response to adjuvant gemcitabine in Japanese pancreatic cancer patients treated with surgery. Eur J Surg Oncol 2012; 38:1051-7. [DOI: 10.1016/j.ejso.2012.08.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 08/05/2012] [Accepted: 08/16/2012] [Indexed: 01/22/2023] Open
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Yamaue H, Miyazawa M, Mizuno N, Okusaka T, Fukutomi A, Ishii H, Ohkawa S, Furukawa M, Maguchi H, Ikeda M, Nishio K, Ohashi Y, Tsunoda T. A Multicenter, Randomized, Placebo-Controlled, Double-Blind Trial with VEGFR2-EPITOPE Peptide and Gemcitabine for Patients with Locally Advanced, Metastatic, or Unresectable Pancreatic Cancer: Pegasus-PC Study. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32148-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Fuchs C, Ikeda M, Okusaka T, Ohkawa S, Mizuno N, Haddad V, McGreivy J, Chang D. A Phase 3 Trial of Ganitumab with Gemcitabine as First-Line Treatment of Metastatic Pancreatic Cancer: A Safety Update from the Gamma Trial. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)31953-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Kodama A, Kamei N, Kamei G, Kongcharoensombat W, Ohkawa S, Nakabayashi A, Ochi M. In vivo bioluminescence imaging of transplanted bone marrow mesenchymal stromal cells using a magnetic delivery system in a rat fracture model. ACTA ACUST UNITED AC 2012; 94:998-1006. [PMID: 22733960 DOI: 10.1302/0301-620x.94b7.28521] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
For the treatment of ununited fractures, we developed a system of delivering magnetic labelled mesenchymal stromal cells (MSCs) using an extracorporeal magnetic device. In this study, we transplanted ferucarbotran-labelled and luciferase-positive bone marrow-derived MSCs into a non-healing femoral fracture rat model in the presence of a magnetic field. The biological fate of the transplanted MSCs was observed using luciferase-based bioluminescence imaging and we found that the number of MSC derived photons increased from day one to day three and thereafter decreased over time. The magnetic cell delivery system induced the accumulation of photons at the fracture site, while also retaining higher photon intensity from day three to week four. Furthermore, radiological and histological findings suggested improved callus formation and endochondral ossification. We therefore believe that this delivery system may be a promising option for bone regeneration.
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Affiliation(s)
- A Kodama
- Hiroshima University, Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan.
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Kobayashi S, Ueno M, Ohkawa S, Andou T, Kameda R, Yamamoto N, Morinaga S. A Retrospective Study of S-1 Monotherapy as Second-line Treatment for Patients with Advanced Biliary Tract Cancer. Jpn J Clin Oncol 2012; 42:800-6. [DOI: 10.1093/jjco/hys102] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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28
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Yoshida T, Kumagai H, Suzuki A, Kobayashi N, Ohkawa S, Odamaki M, Kohsaka T, Yamamoto T, Ikegaya N. Relaxin ameliorates salt-sensitive hypertension and renal fibrosis. Nephrol Dial Transplant 2012; 27:2190-2197. [DOI: 10.1093/ndt/gfr618] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Yoshii T, Ohkawa S. 6629 POSTER Clinical Outcome of Local Recurrence Cases After Endoscopic Mucosal Resection(EMR) for Mucosal Esophageal Squamous-cell Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71940-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ueno M, Ohkawa S, Sugimori K, Kobayashi S, Kaneko T, Taguri M, Morita S. Randomized phase II study of gemcitabine monotherapy versus gemcitabine with an EPA-enriched oral supplement in advanced pancreatic cancer (YCOG001). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Yamada Y, Mizusawa J, Takashima A, Nakamura K, Tsuji Y, Suzuki Y, Amagai K, Yamaguchi K, Konishi K, Yoshino T, Denda T, Koizumi W, Ohkawa S, Kawai H, Kojima H, Nishizaki H, Nishina T, Tsuji A, Fukuda H, Boku N. Molecular prognostic markers in advanced gastric cancer: Correlative study in the Japan Clinical Oncology Group trial JCOG9912. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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32
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Ioka T, Ikeda M, Ohkawa S, Yanagimoto H, Fukutomi A, Sugimori K, Baba H, Yamao K, Shimamura T, Chen J, Mizumoto K, Furuse J, Funakoshi A, Hatori T, Yamaguchi T, Egawa S, Sato A, Ohashi Y, Cheng A, Okusaka T. Randomized phase III study of gemcitabine plus S-1 (GS) versus S-1 versus gemcitabine (GEM) in unresectable advanced pancreatic cancer (PC) in Japan and Taiwan: GEST study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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33
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Morinaga S, Yamamoto N, Shiozawa M, Tamagawa H, Ueno M, Nakamura Y, Miyagi Y, Ohkawa S, Yoichi K, Akaike M. Use of human equilibrative nucleoside transporter 1 to predict survival after adjuvant gemcitabine chemotherapy in resected pancreatic adenocarcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
224 Background: Gemcitabine is a promising adjuvant treatment for patients with resected pancreatic adenocarcinoma. Human equilibrative nucleoside transporter 1 (hENT1) is the major transporter responsible for 2′, 2′-difluoro-2deoxycytidine (gemcitabine) uptake into cells. The aim of this study was to determine the outcomes according to the expression of hENT1 in tumor cells in patients treated with adjuvant gemcitabine chemotherapy after curative resection. Methods: We studied 27 pancreatic adenocarcinoma patients treated with gemcitabine adjuvant chemotherapy after curative resection and 8 gemcitabine naïve patients between 2006 and 2008. The hENT expressions were assessed using immunohistochemistry. The staining intensity of hENT1 protein was assigned a score from 0 to 3 based on staining with 0: no staining, 1: weakly positive, 2: moderately positive, 3: strongly positive. The percentage of positive tumor cells was scored as follows, 0: no positive tumor cell; 1: < 50% positive cells, 2: 51-80% positive cells, 3: > 81% positive cells. The hENT1 score was obtained by calculating the sum of these two scores. Each patients received adjuvant chemotherapy by either protocols as follows; GEM 1,000 mg/m2biweekly × 12 (6 months) or GEM 1,000 mg/m2Days 1,8,15; every 4 weeks for 6 months. Results: 11 patients were assigned to low hENT1 expression group (hENT1 score <4) and 16 patients to high hENT1 group (hENT1 score 4,5,6). The median DFS was 7.3 months (95% CI, 3.6-11.1) in the low hENT1 group, and 9.3 months (95% CI, 4.2-14.5) in the high hENT1 group. The median OS was 11.8 months (95% CI, 6.9- 16.6) in the low hENT1 group, and 22.2 months (95% CI, 11.5-32.9). The high hENT1 group had significantly longer DFS (Log-rank, p=0.04) and OS (p=0.02). In the gemcitabine naïve patients after curative resection, neither DFS nor OS correlated with hENT1 expression. Conclusions: In the pancreatic cancer patients treated with adjuvant gemcitabine chemotherapy after curative resection, both DFS and OS correlated with hENT1 expression. The expression of hENT1 may provides prognostic information and predictive for benefit from gemcitabine in these patients. No significant financial relationships to disclose.
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Affiliation(s)
- S. Morinaga
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - N. Yamamoto
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - M. Shiozawa
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - H. Tamagawa
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - M. Ueno
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - Y. Nakamura
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - Y. Miyagi
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - S. Ohkawa
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - K. Yoichi
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - M. Akaike
- Division of Hepatobiliary and Pancreatic Surgery, Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan; Kanagawa Cancer Center Hospital, Yokohama, Japan; Division of Molecular Pathology, Kanagawa Cancer Center, Yokohama, Japan; Division of Pathology, Kanagawa Cancer Center, Yokohama, Japan
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Zhou C, Matsukawa T, Shimokawara S, Sone M, Yamamoto H, Ohmori K, Yaka T, Okutsu F, Kusano T, Ohkawa S. Influence of experimental palatal plate on mandibular position during continuous [n] phonation and at the physiologic rest position. Odontology 2010; 98:139-43. [PMID: 20652792 DOI: 10.1007/s10266-010-0128-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Accepted: 02/24/2010] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to clarify the influence of an experimental palatal plate on the mandibular position during continuous [n] phonation and at the physiologic rest position. Twenty healthy dentulous volunteers (10 males and 10 females, mean age of 24.4 years) were investigated. Three kinds of experimental plate with a thickness of 3 mm, 5 mm, and 8 mm were fabricated and used for each subject. The mandibular position was recorded by a K7 kinesiograph during continuous [n] phonation and at the physiologic rest position under normal conditions and when the three kinds of plate with different thickness were worn separately. The results showed that the mean interocclusal dimensions during continuous [n] phonation were 0.5 mm vertically and 0.4 mm anteroposteriorly under the normal condition. After insertion of an experimental plate, the interocclusal distance increased a little, but the difference was not statistically significant between the normal condition and any of the three experimental conditions. No significant difference was found between the male and female groups. Furthermore, no significant difference in the interocclusal distance at the physiologic rest position was found between the above comparisons. Within the limitations of this study, we concluded that the mandibular position during continuous [n] phonation and at the physiologic rest position was not significantly influenced by the experimental plates.
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Affiliation(s)
- Chongyang Zhou
- Special Department of Dentistry, Peking University School of Stomatology, Beijing, China
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Takahashi R, Ishii K, Miyamoto N, Yoshikawa T, Shimada K, Ohkawa S, Kakigi T, Yokoyama K. Measurement of gray and white matter atrophy in dementia with Lewy bodies using diffeomorphic anatomic registration through exponentiated lie algebra: A comparison with conventional voxel-based morphometry. AJNR Am J Neuroradiol 2010; 31:1873-8. [PMID: 20634303 DOI: 10.3174/ajnr.a2200] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE DLB is recognized as the second major form of dementia in the elderly. The regional pattern of GM atrophy in DLB highly overlaps that in AD. The aim of this study was to identify the critical pattern of atrophy in DLB by using DARTEL, which provides improved registration accuracy compared with that of conventional VBM. MATERIALS AND METHODS We evaluated 51 patients with probable AD, 43 patients with probable DLB, and 40 age-matched healthy controls. The pattern of GM atrophy in each group was compared by using conventional VBM and VBM-DARTEL. RESULTS Regional patterns of atrophy identified by using conventional VBM differed significantly from those identified by using VBM-DARTEL. A decrease in GM volume in the MTLs in both AD and DLB was identified with VBM-DARTEL; the decrease was greater in patients with AD than in those with DLB. Comparisons with healthy controls revealed that the WM volume of the whole brain was preserved in patients with DLB. In contrast, a severe bilateral decrease in WM in the MTLs was detected in patients with AD. CONCLUSIONS VBM-DARTEL provided more accurate results, and it enabled the identification of more localized morphologic alterations than did conventional VBM. Analysis of WM preservation in DLB could help to differentiate this condition from AD.
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Affiliation(s)
- R Takahashi
- Departments of Neurology, Hyogo Prefectural Rehabilitation Hospital at Nishi-Harima, Tatsuno, Japan
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36
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Suzuki E, Ikeda M, Okusaka T, Nakamori S, Ohkawa S, Nagakawa T, Boku N, Yamagimoto H, Sugimori K, Furuse J. A multicenter phase II of S-1 in gemcitabine-refractory biliary tract cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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37
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Yoshii T, Ohkawa S. Clinical outcome of local recurrence cases after endoscopic mucosal resection (EMR) for Japanese Classification stage 0 esophageal cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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38
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Ueno M, Ohkawa S, Kawano T, Kobayashi S, Miyakawa K, Yoshida T. The usefulness of PET/CT and diffusion-weighted MRI in pancreatic cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Goto H, Ishii K, Uemura T, Miyamoto N, Yoshikawa T, Shimada K, Ohkawa S. Differential diagnosis of dementia with Lewy Bodies and Alzheimer Disease using combined MR imaging and brain perfusion single-photon emission tomography. AJNR Am J Neuroradiol 2010; 31:720-5. [PMID: 20075101 DOI: 10.3174/ajnr.a1926] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Diagnostic performance by MR imaging or by SPECT alone in discriminating DLB patients from AD patients has been estimated previously. However, the performance of a combination of MR imaging and SPECT has not yet been evaluated. Our aim was to evaluate the usefulness of combining MR imaging and SPECT to discriminate mild DLB from AD. MATERIALS AND METHODS Nineteen patients with mild DLB and 19 age- and cognitive decline-matched patients with mild AD underwent both SPECT and MR imaging. Hippocampal, occipital, and striatal volume and SPECT count ratios were compared. Linear discriminant and ROC analyses were performed by using the parameters of striatal volume and the occipital SPECT ratio. RESULTS The striatal volume ratio in the DLB group was significantly lower than that in the AD group. The occipital SPECT ratio in the DLB group was lower than that in the AD group. The mean area under the ROC curve from combined MR imaging and SPECT (AUC = 0.898) was higher than that from MR imaging (AUC = 0.679) or SPECT (AUC = 0.798) alone. CONCLUSIONS By combining MR imaging and SPECT, we were able to distinguish patients with mild DLB from those with AD with a high level of accuracy. Our findings suggest that combining MR imaging and SPECT modalities is a useful and practical approach for diagnostically differentiating DLB from AD.
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Affiliation(s)
- H Goto
- Department of Radiology and Nuclear Medicine, Hyogo Brain and Heart Center, Himeji, Japan
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40
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Morizane C, Okusaka T, Ikeda M, Furuse J, Ohkawa S, Nakachi K, Suzuki E, Ueno M. 6594 Phase II study of gemcitabine as a fixed dose rate infusion and S-1 combination therapy (FGS) in gemcitabine-refractory pancreatic cancer patients. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71315-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Abstract
e15629 Background: The standard chemotherapy of advanced pancreatic cancer is still gemcitabine and recently gemcitabine + EGFR tyrosine kinase inhibitor (TKI)is noted to be positive on Phase III study. In lung cancer, EGFR mutations (the deletion of exon 19, the point mutation of exon 18, 21) have been reported to be correlated with the effect of EGFR TKI. On the other hand, such EGFR mutations were not reported to be recognized by the direct sequencing method in pancreatic cancer. This time we examined EGFR expressions and EGFR mutations in advanced pancreatic cancer. Methods: We examined EGFR expressions immunohistochemically and EGFR mutations by Loop-Hybrid Mobility Shift Assay (LH-MSA) which is more sensitive than the direct sequencing method in the tissue obtained from percutaneous biopsies in advanced pancreatic cancer patients. In addition we examined the correlation between EGFR expressions and survivals by the log-rank test. Results: The subjects were 31 inoperable pancreatic cancer patients. Patients received chemotherapy (gemcitabine: 10, S-1: 8, gemcitabine+S-1: 12, no treatment: 1).The UICC stages were as follows:stage II; 2, stage III; 6, stage IV; 23. The tissues were obtaind from liver; 12, pancreas; 19. EGFR expressions were positive; 15, negative; 16. EGFR expressions were not correlated with survival (p=0.386). Although LH-MSA were performed successfully in all patients, the same EGFR mutations as lung cancer were not detected. Conclusions: EGFR expressions were not correlated with survivals and the same EGFR mutations as lung cancer were not detected in inoperable advanced pancreatic cancer. No significant financial relationships to disclose.
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Affiliation(s)
- M. Ueno
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - S. Ohkawa
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - Y. Sakamoto
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - K. Miyakawa
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - Y. Miyagi
- Kanagawa Cancer Center Hospital, Yokohama, Japan
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Ishii H, Furuse J, Boku N, Okusaka T, Ikeda M, Ohkawa S, Fukutomi A, Hamamoto Y, Nakamura K, Fukuda H. Phase II study of gemcitabine chemotherapy alone for locally advanced pancreatic carcinoma: JCOG 0506. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15578 Background: Fluorouracil (5-FU) chemoradiotherapy has been accepted as standard care for locally advanced pancreatic cancer (LAPC); however, it has not been shown to be superior to chemotherapy alone in gemcitabine (Gem) era. The present multicenter phase II study was conducted to evaluate the efficacy and the safety for the screening of Gem monotherapy against LAPC. Methods: Eligibility criteria included the following: patients (pts) with histologically or cytologically proven pancreatic adenocarcinoma or adenosquamous carcinoma, pts with UICC clinical stage III (T4N0–1 and M0), all lesions are assumed to be included in the radiation field of 15 cm square, age 20 or older, no prior treatment for LAPC, ECOG performance status of 0, 1 or 2, and adequate organ function. Gem was given intravenously at a dose of 1,000 mg/m2 over 30 minutes on days 1, 8 and 15, repeated every 4 weeks until disease progression. The primary endpoint was %1-year overall survival. A sample size of 50 was required with one-sided alpha of 0.20, beta of 0.10, expected %1-year survival of 40% and threshold %1-year survival of 25%. Results: Between Jan. 06 and Feb. 07, 50 pts from 14 institutions were registered. Patient characteristics were: median age; 67.5 (45–80), male/female; 35/15, PS 0/1/2; 30/20/0, pancreatic head/body-tail; 26/24. The major grade 3–4 adverse events were neutropenia (62%), leucopenia (32%), thrombocytopenia (18%), fatigue (12%), infection-biliary tree (10%), anorexia (8%), and nausea (6%). Hematological toxicity was mostly transient and there was no episode of infection with grade 3–4 neutropenia. There were no treatment-related deaths during the study. Serum CA 19–9 level was reduced by >50% in 37.5% of 40 pts with baseline CA19–9 >100U/ml. Up to the final follow-up in Apr. 08, the median overall survival was 1.25 years (95% CI, 1.06–1.71 years) with a %1-year survival of 64.8% (95% CI, 49.6–76.4%), and the null hypothesis (%1-y survival=25%) was rejected (p<0.0001). Conclusions: Gem monotherapy demonstrated far better survival than historical data of 5-FU chemoradiotherapy in LAPC pts with mild toxicities. In future randomized trial, we will select Gem chemotherapy as a referential arm to compare with the chemoradiotherapy regimen which is under phase II evaluation for LAPC. No significant financial relationships to disclose.
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Affiliation(s)
- H. Ishii
- Cancer Institute Hospital, Tokyo, Japan; Kyorin University, Mitaka, Tokyo, Japan; Shizuoka Cancer Center, Nagaizumi, Japan; National Cancer Center, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kanagawa Cancer Center, Yokohama, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Tochigi Cancer Center, Utsunomiya, Japan
| | - J. Furuse
- Cancer Institute Hospital, Tokyo, Japan; Kyorin University, Mitaka, Tokyo, Japan; Shizuoka Cancer Center, Nagaizumi, Japan; National Cancer Center, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kanagawa Cancer Center, Yokohama, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Tochigi Cancer Center, Utsunomiya, Japan
| | - N. Boku
- Cancer Institute Hospital, Tokyo, Japan; Kyorin University, Mitaka, Tokyo, Japan; Shizuoka Cancer Center, Nagaizumi, Japan; National Cancer Center, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kanagawa Cancer Center, Yokohama, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Tochigi Cancer Center, Utsunomiya, Japan
| | - T. Okusaka
- Cancer Institute Hospital, Tokyo, Japan; Kyorin University, Mitaka, Tokyo, Japan; Shizuoka Cancer Center, Nagaizumi, Japan; National Cancer Center, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kanagawa Cancer Center, Yokohama, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Tochigi Cancer Center, Utsunomiya, Japan
| | - M. Ikeda
- Cancer Institute Hospital, Tokyo, Japan; Kyorin University, Mitaka, Tokyo, Japan; Shizuoka Cancer Center, Nagaizumi, Japan; National Cancer Center, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kanagawa Cancer Center, Yokohama, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Tochigi Cancer Center, Utsunomiya, Japan
| | - S. Ohkawa
- Cancer Institute Hospital, Tokyo, Japan; Kyorin University, Mitaka, Tokyo, Japan; Shizuoka Cancer Center, Nagaizumi, Japan; National Cancer Center, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kanagawa Cancer Center, Yokohama, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Tochigi Cancer Center, Utsunomiya, Japan
| | - A. Fukutomi
- Cancer Institute Hospital, Tokyo, Japan; Kyorin University, Mitaka, Tokyo, Japan; Shizuoka Cancer Center, Nagaizumi, Japan; National Cancer Center, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kanagawa Cancer Center, Yokohama, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Tochigi Cancer Center, Utsunomiya, Japan
| | - Y. Hamamoto
- Cancer Institute Hospital, Tokyo, Japan; Kyorin University, Mitaka, Tokyo, Japan; Shizuoka Cancer Center, Nagaizumi, Japan; National Cancer Center, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kanagawa Cancer Center, Yokohama, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Tochigi Cancer Center, Utsunomiya, Japan
| | - K. Nakamura
- Cancer Institute Hospital, Tokyo, Japan; Kyorin University, Mitaka, Tokyo, Japan; Shizuoka Cancer Center, Nagaizumi, Japan; National Cancer Center, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kanagawa Cancer Center, Yokohama, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Tochigi Cancer Center, Utsunomiya, Japan
| | - H. Fukuda
- Cancer Institute Hospital, Tokyo, Japan; Kyorin University, Mitaka, Tokyo, Japan; Shizuoka Cancer Center, Nagaizumi, Japan; National Cancer Center, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Kanagawa Cancer Center, Yokohama, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Tochigi Cancer Center, Utsunomiya, Japan
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Niwa T, Ueno M, Ohkawa S, Yoshida T, Doiuchi T, Ito K, Inoue T. Advanced pancreatic cancer: the use of the apparent diffusion coefficient to predict response to chemotherapy. Br J Radiol 2009; 82:28-34. [PMID: 19095814 DOI: 10.1259/bjr/43911400] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The purpose of this study was to determine if the apparent diffusion coefficient (ADC) on diffusion-weighted MRI could predict the response of patients with advanced pancreatic cancer to chemotherapy. Diffusion-weighted MRI was performed in 63 consecutive patients with advanced pancreatic cancer who were subsequently treated with chemotherapy. The ADC values of the primary tumour with a middle b-value (400 s mm(-2)) and a high b-value (1000 s mm(-2)) were determined; cystic or necrotic components were avoided. The patients were classified into two groups: (i) those with progressive disease and (ii) those who were stable 3 months and 6 months after initial treatment. The groups were compared with respect to the ADC and clinical factors, including gender, age, Union International Contre le Cancer (UICC ) stage, initial tumour size and chemotherapy agents used. Local tumour progression rates were evaluated using the Kaplan-Meier method. The middle b-value ADC of the pancreatic cancers ranged from 0.93-2.42 x10(-3) mm(2) s(-1) (mean, 1.50 x10(-3) mm(2) s(-1)), and the high b-value ADC ranged from 0.72-1.88 x10(-3) mm(2) s(-1) (mean, 1.20 x10(-3) mm(2) s(-1)). The high b-value ADC was significantly different between the progressive and stable groups at 3 months' and 6 months' follow-up (p = 0.03 and p = 0.04, respectively). The rate of tumour progression was significantly higher in those with a lower high b-value ADC than in those with a higher b-value ADC (median progression time, 140 days vs 182 days; p = 0.01). In conclusion, a lower high b-value ADC in patients with advanced pancreatic cancer may be predictive of early progression in chemotherapy-treated patients.
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Affiliation(s)
- T Niwa
- Department of Radiology, Kanagawa Cancer Centre, Asahi-ku, Yokohama, Japan.
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Zhang H, Sone M, Yamamoto H, Ohmori K, Yaka T, Ohkawa S. Influence of experimental palatal plate on mandibular position during continuous phonation of [n]. J Prosthodont Res 2009; 53:38-40. [DOI: 10.1016/j.jpor.2008.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2008] [Accepted: 07/18/2008] [Indexed: 11/24/2022]
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Ueno M, Ohkawa S, Sugimasa Y, Sakamoto Y, Miyakawa K, Sugano N, Morinaga S. The significance of cancer pain in pancreatic cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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46
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Rino Y, Yukawa N, Yamada T, Imada T, Morinaga S, Ohkawa S, Miyakawa K, Ueno M, Tarao K. Reduction therapy of ALT levels and prevention of HCC development in patients with HCV-associated cirrhosis. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1529 Background: Approximately 30 million people worldwide are estimated to have liver cirrhosis (LC) associated with hepatitis C virus (HCV). In addition, patients with HCV-associated liver cirrhosis (HCV-LC) have a high risk of developing hepatocellular carcinoma (HCC). Namely, 60–80% of the patients may develop HCC in 10 years. So, preventing these patients from developing HCC is an urgent problem to be solved. To find a way to prevent the development of hepatocellular carcinoma (HCC) from hepatitis C-virus associated liver cirrhosis (HCV-LC), an analysis of the HCV-LC patients who had reduction therapy of ALT levels was performed. Patients and Methods: Seventy-four consecutive HCV-LC patients of Child Stage A were followed for > 10 years for the development of HCC. They were divided into two groups: In group A, the reduction therapy for ALT levels is aggressively performed and in group B, the reduction therapy was not performed aggressively. Results: Initial ALT was higher in group A than in group B, but there was no significance. After reduction therapy, ALT level was significantly high in group A in the first year. However, there were no significant differences between ALT levels in groups A and B of after the second year. In total, 39 patients out of 74 (52.7%) developed HCC within 13 years from the beginning of the study and 35 patients did not developed HCC in the same observation period. The incidence of HCC development in group B [65.7% (23/35)] was significantly higher than in group A [41.0% (16/39)] (p=0.039). The median HCC developing time in group A (12.8 years) was significantly longer than in group B (3.8 years) (p=0.0013). Multivariate analysis demonstrated that reduction therapy and ALT levels were the significant factors affecting HCC development. The incidence of HCC development in group B was 5.8 times higher than in group A. The high and unclassified ALT groups were 4.6 times and 2.2 times higher than in the low ALT group. Conclusion: The chances of surviving for more than 10 years without developing HCC in the HCV-LC patients of Child Stage A were far more favorable in group A than in group B. These results suggest that aggressive reduction therapy for ALT levels in HCV-LC patients could significantly prevent HCC development. No significant financial relationships to disclose.
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Affiliation(s)
- Y. Rino
- Yokohama City University School of Medicine, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - N. Yukawa
- Yokohama City University School of Medicine, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - T. Yamada
- Yokohama City University School of Medicine, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - T. Imada
- Yokohama City University School of Medicine, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - S. Morinaga
- Yokohama City University School of Medicine, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - S. Ohkawa
- Yokohama City University School of Medicine, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - K. Miyakawa
- Yokohama City University School of Medicine, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - M. Ueno
- Yokohama City University School of Medicine, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
| | - K. Tarao
- Yokohama City University School of Medicine, Yokohama, Japan; Kanagawa Cancer Center, Yokohama, Japan
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Ueno H, Okusaka T, Furuse J, Yamao K, Funakoshi A, Boku N, Ohkawa S, Makimoto A, Sato T. A multicenter phase II study of gemcitabine and S-1 combination therapy (GS therapy) in patients with metastatic pancreatic cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4550] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4550 Background: As shown in our previous phase I study (Oncology 2005, 69:421–427), gemcitabine and S-1 combination therapy (GS therapy) appears to be feasible and effective against advanced pancreatic cancer. The present multicenter phase II study was conducted to confirm the efficacy and toxicity of GS therapy for metastatic pancreatic cancer. Methods: Patients with histologically or cytologically proven pancreatic adenocarcinoma with at least one measurable metastatic lesion were eligible for the study. Other eligibility criteria included: no previous treatment for pancreatic cancer except surgery, age =20 and =74 years, ECOG performance status of 0 or 1, and adequate organ function. Gemcitabine was given intravenously at a dose of 1,000 mg/m2 over 30 min on days 1 and 8, and S-1 was given orally at a dose of 40 mg/m2 twice daily from day 1 to day 14, repeated every 3 weeks. The objective response rate was assessed according to RECIST. Results: A total of 55 patients from 10 institutions were enrolled between October 2004 and July 2005. The efficacy and toxicity were analyzed in 54 patients who received at least one course of GS therapy. The median number of treatment courses was 7 (range, 1–24+). Although no complete response was seen, a partial response was achieved in 24 patients, resulting in an overall response rate of 44% (95% CI, 30.9–58.6%). Twenty-six patients (48%) had stable disease. The median progression-free survival was 5.9 months (95% CI, 4.1–6.9 months) and the median overall survival was 10.1 months (95% CI, 8.5–10.8 months) with a 1-year survival rate of 33%. The major grade 3–4 toxicities were neutropenia (80%), leucopenia (59%), thrombocytopenia (22%), anorexia (17%), rash (7%), nausea (6%) and fatigue (6%). Hematological toxicity was mostly transient and there was only one episode of infection with grade 3–4 neutropenia. No treatment-related deaths occurred during the study. Conclusions: GS therapy produced a high response rate and good survival associated with an acceptable toxicity profile in patients with metastatic pancreatic cancer. A randomized phase III trial to confirm the efficacy of GS therapy is planned. No significant financial relationships to disclose.
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Affiliation(s)
- H. Ueno
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Chiba, Japan; Aichi Cancer Center, Aichi, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Kanagawa Cancer Center, Kanagawa, Japan; Kyoto University School of Public Health, Kyoto, Japan
| | - T. Okusaka
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Chiba, Japan; Aichi Cancer Center, Aichi, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Kanagawa Cancer Center, Kanagawa, Japan; Kyoto University School of Public Health, Kyoto, Japan
| | - J. Furuse
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Chiba, Japan; Aichi Cancer Center, Aichi, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Kanagawa Cancer Center, Kanagawa, Japan; Kyoto University School of Public Health, Kyoto, Japan
| | - K. Yamao
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Chiba, Japan; Aichi Cancer Center, Aichi, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Kanagawa Cancer Center, Kanagawa, Japan; Kyoto University School of Public Health, Kyoto, Japan
| | - A. Funakoshi
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Chiba, Japan; Aichi Cancer Center, Aichi, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Kanagawa Cancer Center, Kanagawa, Japan; Kyoto University School of Public Health, Kyoto, Japan
| | - N. Boku
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Chiba, Japan; Aichi Cancer Center, Aichi, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Kanagawa Cancer Center, Kanagawa, Japan; Kyoto University School of Public Health, Kyoto, Japan
| | - S. Ohkawa
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Chiba, Japan; Aichi Cancer Center, Aichi, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Kanagawa Cancer Center, Kanagawa, Japan; Kyoto University School of Public Health, Kyoto, Japan
| | - A. Makimoto
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Chiba, Japan; Aichi Cancer Center, Aichi, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Kanagawa Cancer Center, Kanagawa, Japan; Kyoto University School of Public Health, Kyoto, Japan
| | - T. Sato
- National Cancer Center Hospital, Tokyo, Japan; National Cancer Center Hospital East, Chiba, Japan; Aichi Cancer Center, Aichi, Japan; National Kyushu Cancer Center, Fukuoka, Japan; Shizuoka Cancer Center, Shizuoka, Japan; Kanagawa Cancer Center, Kanagawa, Japan; Kyoto University School of Public Health, Kyoto, Japan
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Ueno M, Ohkawa S, Niwa T, Yoshida T, Morinaga S, Sugimasa Y. The correlation of perfusion-weighted MRI with VEGF in resected pancreatic cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15092 Background: Perfusion-weighted magnetic resonance imaging (MRI) can detect angiogenesis in brain malignant tumors, and as angiogenesis increases in various carcinomas the prognosis becomes worse. We evaluated the usefulness of perfusion-weighted MRI as a prognostic predictor in pancreatic cancer patients in ASCO 2005. This time, we examined the correlation of perfusion-weighted MRI with vascular endothelial growth factor (VEGF) and microvessel density (MVD) immunohistochemically in resected pancreatic cancer patients. Methods: Perfusion-weighted MRI was performed on 14 consecutive resected pancreatic cancer cases. Imaging acquisition was continually repeated with echo-planar sequence every 2 sec for 2 min with bolus injection of gadolinium. We made the time intensity curve of perfusion-weighted images and calculated the signal ratio (SR). We investigated the expressions of VEGF and CD34 (for calculating MVD) immunohistochemically. MVD was assessed per 200x field. We compared SR with VEGF expression and MVD. The correlations were evaluated with t-test. Results: All cases showed transient decreases in tumor signal intensity (SR range: 18.2–66.0%) in perfusion-weighted MRI. The expressions of VEGF were divided into two groups (high and low expression). MVD ranged from 6 to 34 and was divided into two groups at the median value. The correlation of SR in perfusion-weighted MRI with VEGF expression was significant (p=0.002). High SR correlated with high VEGF expression. The correlation of SR in perfusion-weighted MRI with MVD was not significant. Conclusions: Perfusion- weighted MRI correlated with VEGF expression in pancreatic cancer. No significant financial relationships to disclose.
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Affiliation(s)
- M. Ueno
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - S. Ohkawa
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - T. Niwa
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - T. Yoshida
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - S. Morinaga
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - Y. Sugimasa
- Kanagawa Cancer Center Hospital, Yokohama, Japan
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Ohkawa S, Amano A, Ueno M, Miyakawa K, Sugimori K, Tanaka K, Kida M. A phase II multicentric trial of combined chemotherapy with gemcitabine plus S-1 in patients with advanced pancreatic cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15129 Background: While gemcitabine (GEM) is the standard drug for chemotherapy against advanced pancreatic cancer, the development of multidrug therapies for improved outcome is important. We conducted multicentric combined chemotherapy with GEM and S-1 trial and reported the results of the phase I trial last year. And this phase II study evaluated the efficacy and feasibility. Methods: The subjects had unresectable pancreatic ductal cancer. Eligibility criteria were pathologically-proven, Karnofsky performance status 80 to 100%, age 20 to 74 years, adequate hematological, renal, and liver functions and written informed consent. The method of administration was single administration of GEM on the first day of the week 1000 mg/m2, with concurrent administration of S-1 at 80 (<1.5 m2) to 100 (=1.5 m2) mg/day × 7 days, repeated every other week until the progressive disease or life threatening adverse events. This administration dose was determined from the result of the phase I study. The primary endpoint was median survival time. And the secondary endpoints were the overall response rate and the toxicities. Results: 40 patients(pts) were enrolled. Average age was 62.9±8.3 years (34–73 years). Thirty nine pts were conducted this therapy except one who refused this study before the start of administration. Thirty eight pts were evaluable for response, partial response, stable disease, progressive disease were observed in 7 (17.5%), 21 (52.5%) and 10 pts (25.0%), respectively. The median survival time at this stage is 276±51 days in this ongoing study. Grade 3 and 4 toxicities were mainly leucocytes(10 pts), neutrophils(8 pts) and anorexia(6 pts). Conclusions: The GEM plus S-1 combined chemotherapy is effective and feasible in patients with advanced pancreatic cancer. No significant financial relationships to disclose.
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Affiliation(s)
- S. Ohkawa
- Kanagawa Cancer Center Hospital, Yokohama, Japan; Yokohama City University School of Medicine, Yokohama, Japan; Kitasato University East Hospital, Sagamihara, Japan
| | - A. Amano
- Kanagawa Cancer Center Hospital, Yokohama, Japan; Yokohama City University School of Medicine, Yokohama, Japan; Kitasato University East Hospital, Sagamihara, Japan
| | - M. Ueno
- Kanagawa Cancer Center Hospital, Yokohama, Japan; Yokohama City University School of Medicine, Yokohama, Japan; Kitasato University East Hospital, Sagamihara, Japan
| | - K. Miyakawa
- Kanagawa Cancer Center Hospital, Yokohama, Japan; Yokohama City University School of Medicine, Yokohama, Japan; Kitasato University East Hospital, Sagamihara, Japan
| | - K. Sugimori
- Kanagawa Cancer Center Hospital, Yokohama, Japan; Yokohama City University School of Medicine, Yokohama, Japan; Kitasato University East Hospital, Sagamihara, Japan
| | - K. Tanaka
- Kanagawa Cancer Center Hospital, Yokohama, Japan; Yokohama City University School of Medicine, Yokohama, Japan; Kitasato University East Hospital, Sagamihara, Japan
| | - M. Kida
- Kanagawa Cancer Center Hospital, Yokohama, Japan; Yokohama City University School of Medicine, Yokohama, Japan; Kitasato University East Hospital, Sagamihara, Japan
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Abstract
14043 Background: 18F-fluorodeoxyglucose (FDG) PET is a new diagnostic imaging technique that takes advantage of increased glucose metabolism by the tumor cells. High uptake of FDG is reportedly associated with poor survival in head and neck cancer (Heikki et al., 1997, Nuclear Oncology). FDG uptake diminishes with elevated levels of plasma glucose. We herein evaluated the usefulness of FDG-PET in predicting the prognosis of advanced pancreatic carcinoma (APC). Methods: FDG-PET was performed on 32 consecutive patients with APC between July 2001 and April 2004. The patients fasted for at least 5 hr before the study. The plasma glucose level was controlled under 150 mg/dl by using oral antidiabetic or insulin therapy in advance. FDG-PET images were acquired 45 min after intravenous injection of FDG. We did not measure the plasma glucose level directly before imaging. The FDG uptake in the primary tumor was quantitated as the standardized uptake value (SUV), and the maximum SUV (SUVmax) was measured in the regions of interest. All of the 32 APC patients received chemotherapy (26: gemcitabine, 1: gemcitabine + UFT, 5: TS-1). We analyzed the correlation between SUVmax and the overall survival. Then, we excluded the diabetics (n = 8) and compared SUV in the non-diabetic patients (n = 24). The overall survival curve was plotted according to the method of Kaplan and Meier. The difference in the overall survival was calculated using the log-rank test, and a multivariate analysis was conducted. Results: 32 patients were examined. All cases showed FDG uptake in the pancreatic tumor (SUVmax ranged from 2.73 to 9.67). The overall survival ranged from 38 to 945 days with a median of 261 days.These patients were classified into two groups at a median SUVmax value of 4.81. There was no significant difference in the overall survival between these two groups (p > 0.05). The non-diabetic patients (n = 24) were classified into two groups at a median SUVmax value of 5.51. The high SUVmax group had shorter overall survival than the low SUVmax group (p = 0.039). The multivariate analysis using Cox hazard model also revealed that SUVmax was a significant, independent factor that influenced the survival (p = 0.043) in the non-diabetic patients. Conclusions: FDG-PET may be a useful modality in determining the prognosis of APC. No significant financial relationships to disclose.
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Affiliation(s)
- M. Ueno
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - S. Ohkawa
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - K. Miyakawa
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - A. Amano
- Kanagawa Cancer Center Hospital, Yokohama, Japan
| | - T. Masaki
- Kanagawa Cancer Center Hospital, Yokohama, Japan
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